Contraceptive choices in HIV infected and HIV at-risk adolescent females

Belzer, Marvin; Rogers, Audrey Smith; Camarca, Margaret; Fuchs, Dana N; Peralta, Lígia; Tucker, Diane; Durako, Stephen

doi:10.1016/s1054-139x(01)00282-8

Cited by 31 publications

(37 citation statements)

References 23 publications

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“…Out of 67 pregnancies, 18 occurred in centres (three of 12) with dedicated adolescent HIV services; however, most of these pregnancies preceded the development of such specialist services. As other studies have reported [6,11], there were significant and complex psychosocial problems among this group. About half (44%; 22 of 50) lived alone, 58% (36 of 62) had housing problems, 10% (five of 49) had a history of domestic violence, 45% (18 of 40) reported a history of sexual abuse and over half of the women (62%; 34 of 55) encountered financial difficulties.…”

Section: Pregnancy In Hiv-infected Teenagers 121supporting

confidence: 63%

“…Studies of HIV-infected adolescents have noted a high prevalence of psychosocial problems, recreational drug use and sexual risk-taking behaviour as well as poor uptake of nonbarrier contraception and high rates of sexually transmitted infections (STIs) [3][4][5][6][7][8][9]. There is significant overlap between the social, demographic and behavioural determinants of teenage pregnancy and the characteristics of adolescents living with HIV [10].…”

Section: Introductionmentioning

confidence: 99%

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Pregnancy in HIV-infected teenagers in London

et al. 2010

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There were 67 pregnancies in 58 young women, of whom one was known to have acquired HIV vertically. The overall mother-to-child transmission (MTCT) rate of HIV was 1.5% (one of 66). There were 66 live births. Median ages at HIV diagnosis and conception were 17 and 18 years, respectively. Sixty-three per cent of women were diagnosed with HIV infection through routine antenatal screening. Eighty-two per cent of pregnancies (41 of 50) were unplanned, with 65% of women (26 of 40) using no contraception. Forty-three per cent of the women (20 of 46) had a past history of a sexually transmitted infection (STI). In 63 pregnancies, antiretroviral therapy was started postconception, with prevention of HIV MTCT the only indication in 81% of cases. Fifty-eight per cent of those on highly active antiretroviral therapy (HAART) had an undetectable HIV viral load by delivery. Eighty-seven per cent were uncomplicated pregnancies. Seventy-one per cent delivered by Caesarean section and 21% (14 of 64) had a preterm delivery (o37 weeks). In the 12 months after delivery, 45% of women received contraceptive advice and 25% of women became pregnant again. ConclusionObstetric and virological outcomes were favourable in this group of HIV-infected young women. However, the majority of pregnancies were unplanned with poor documentation of contraception use and advice and low rates of STI screening. A quarter of women conceived again within 12 months of delivery. Effective measures to reduce STIs, unplanned pregnancies and onward HIV transmission in HIV-infected teenagers are needed. Studies exploring pregnancy in HIV-infected adolescents are limited. The largest described 1183 live births in 1090 pregnant adolescents in the United States, the majority of whom had acquired HIV infection sexually [11]. Most pregnancies were unplanned (83%) and occurred in teenagers who had previously been pregnant (67%).A prospective cohort study of 638 vertically infected girls, again in the USA, reported 45 pregnancies, with 17% of girls experiencing a first pregnancy by their 19th birthday [8]. Of the 32 pregnancies resulting in live births, one infant was HIV-infected, 29 were uninfected and two had unknown infection status. Chibber and Khurranna also reported favourable obstetric outcomes and no cases of vertical transmission in a study of 30 pregnant vertically infected adolescents in India [12]. Other case series have described similar findings [13][14][15]. In a small European study, there were nine live births with no mother-to-child transmissions [16]. To date there have been no studies in the UK looking at pregnancy in teenagers living with HIV.In this study we reviewed the pregnancies of 58 HIVinfected teenagers attending for care at 12 London hospitals. We explore the medical and social features of this group and describe their sexual and reproductive health issues, their response to antiretroviral therapy (ART) and pregnancy outcome. MethodsWe conducted a retrospective case note review of HIVinfected pregnant female patients aged between 13 and...

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Section: Pregnancy In Hiv-infected Teenagers 121supporting

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Pregnancy in HIV-infected teenagers in London

et al. 2010

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show abstract

“…Their contraception practices have significant social ramifications in terms of risk of heterosexual transmission, re-infection and vertical transmission [3]. There are limited data that explore contraceptive choice and decision-making among these young women [4,5]. Some research has demonstrated that HIV positive young women engage in reproductive decision-making that is similar to HIV negative teens [5].…”

Section: Introductionmentioning

confidence: 99%

“…and another contraceptive when a couple is not attempting to conceive is the standard recommendation but, it is practiced by a minority of adolescent couples [4,9,10]. HIV infected adolescents reported prior use of dual protection during 16% of their visits [4].…”

Section: Introductionmentioning

confidence: 99%

“…HIV infected adolescents reported prior use of dual protection during 16% of their visits [4]. Previous international studies have demonstrated that HIV positive adolescent and adult women are more likely to request injectable contraceptives than their HIV negative peers [4,9,[11][12][13]. Risk of HIV acquisition or progression among hormonal contraception users has been a recent concern based on international trials [14].…”

Section: Introductionmentioning

confidence: 99%

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